Annals of Coloproctology

Original Articles

CRC

Impact of iron-deficiency anemia on short-term outcomes after resection of colorectal cancer liver metastasis: a US National (Nationwide) Inpatient Sample (NIS) analysis: Ko-Chao Lee, Yu-Li Su, Kuen-Lin Wu, Kung-Chuan Cheng, Ling-Chiao Song, Chien-En Tang, Hong-Hwa Chen, Kuan-Chih Chung; Ann Coloproctol. 2025;41(2):119-126. Published online April 24, 2025; DOI: https://doi.org/10.3393/ac.2024.00591.0084

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Abstract PDF Supplementary Material: Purpose
Colorectal cancer (CRC) often spreads to the liver, necessitating surgical treatment for CRC liver metastasis (CRLM). Iron-deficiency anemia is common in CRC patients and is associated with fatigue and weakness. This study investigated the effects of iron-deficiency anemia on the outcomes of surgical resection of CRLM.
Methods
This population-based, retrospective study evaluated data from adults ≥20 years old with CRLM who underwent hepatic resection. All patient data were extracted from the 2005–2018 US National (Nationwide) Inpatient Sample (NIS) database. The outcome measures were in-hospital outcomes including 30-day mortality, unfavorable discharge, and prolonged length of hospital stay (LOS), and short-term complications such as bleeding and infection. Associations between iron-deficiency anemia and outcomes were determined using logistic regression analysis.
Results
Data from 7,749 patients (representing 37,923 persons in the United States after weighting) were analyzed. Multivariable analysis revealed that iron-deficiency anemia was significantly associated with an increased risk of prolonged LOS (adjusted odds ratio [aOR], 2.76; 95% confidence interval [CI], 2.30–3.30), unfavorable discharge (aOR, 2.42; 95% CI, 1.83–3.19), bleeding (aOR, 5.05; 95% CI, 2.92–8.74), sepsis (aOR, 1.60; 95% CI, 1.04–2.46), pneumonia (aOR, 2.54; 95% CI, 1.72–3.74), and acute kidney injury (aOR, 1.71; 95% CI, 1.24–2.35). Subgroup analyses revealed consistent associations between iron-deficiency anemia and prolonged LOS across age, sex, and obesity status categories.
Conclusion
In patients undergoing hepatic resection for CRLM, iron-deficiency anemia is an independent risk factor for prolonged LOS, unfavorable discharge, and several critical postoperative complications. These findings underscore the need for proactive anemia management to optimize surgical outcomes.

Comparison of Delorme-Thiersch Operation Outcomes in Men and Women With Rectal Prolapse: Keehoon Hyun, Seo-Gue Yoon; Ann Coloproctol. 2019;35(5):262-267. Published online October 31, 2019; DOI: https://doi.org/10.3393/ac.2018.10.15.1

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Purpose
The laparoscopic rectopexy has become increasingly popular with verified stability, surgical route selection should be tailored to individual patient characteristics rather than operative risk. The perineal approach is useful in young male patients who need to preserve fertility. This study aimed to compare the characteristics of men and women who underwent Delorme-Thiersch procedures and analyze the postoperative outcomes of the perineal approach by sex.
Methods
We retrospectively reviewed the medical records of 293 patients who underwent Delorme-Thiersch operations in Seoul Song Do Colorectal Hospital between January 2011 and September 2017. Patient clinical characteristics and postoperative complications were analyzed by sex. We analyzed surgical outcomes with preoperative and 3-month postoperative incontinence questionnaires, constipation levels, and anal manometry.
Results
In this study, men with rectal prolapse were younger than women with the same condition. American Society of Anesthesiologists physical status classifications were higher in women and women had more L-spine X-ray and pudendal nerve terminal motor latency test abnormalities. Anorectal manometry pressures were higher in men. Men also had longer operation times and hospital stays and more postoperative complications (8 T ring infections, 6 patients with bleeding, 3 with strictures, 2 with severe pain, and 2 with rectal perforations). The recurrence rate was higher among women.
Conclusion
Men with rectal prolapse were younger, healthier, and had relatively better anorectal function than women. The Delorme-Thiersch operation in men promoted lower recurrence rates and was advantageous in preserving the fertility of young patients, but the incidence of complications was also higher in men. Adequate counseling and preparation for the possibility of complications are needed.

Citations

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Assessment of Laparoscopic Posterior Mesh Rectopexy for Complete Rectal Prolapse: A Case Series with Review of Literature
Vishal Chawda, Abhijit Joshi
International Journal of Recent Surgical and Medical Sciences.2023; 09(01): 059. CrossRef
A comparative study on the surgical options for male rectal prolapse
Han Deok Kwak, Jun Seong Chung, Jae Kyun Ju
Journal of Minimal Access Surgery.2022; 18(3): 426. CrossRef
Clinical outcomes of surgical management for recurrent rectal prolapse: a multicenter retrospective study
Kwang Dae Hong, Keehoon Hyun, Jun Won Um, Seo-Gue Yoon, Do Yeon Hwang, Jaewon Shin, Dooseok Lee, Se-Jin Baek, Sanghee Kang, Byung Wook Min, Kyu Joo Park, Seung-Bum Ryoo, Heung-Kwon Oh, Min Hyun Kim, Choon Sik Chung, Yong Geul Joh
Annals of Surgical Treatment and Research.2022; 102(4): 234. CrossRef
Longer prolapsed rectum length increases recurrence risk after Delorme’s procedure
Taro Tanabe, Emi Yamaguchi, Takuya Nakada, Risa Nishio, Kinya Okamoto, Tetsuo Yamana
Annals of Coloproctology.2022; 38(4): 314. CrossRef
Perineal stapled prolapse resection in combination with Thiersch operation for relapsed rectal prolapse: a case report
Teppei Kamada, Hironori Ohdaira, Junji Takahashi, Yoshinobu Fuse, Wataru Kai, Keigo Nakashima, Yuichi Nakaseko, Norihiko Suzuki, Masashi Yoshida, Takeo Usui, Yutaka Suzuki
Surgical Case Reports.2021;[Epub] CrossRef

Distribution and Impact of the Visceral Fat Area in Patients With Colorectal Cancer: Hyeon Yu, Yong-Geul Joh, Gyung-Mo Son, Hyun-Sung Kim, Hong-Jae Jo, Hae-Young Kim; Ann Coloproctol. 2016;32(1):20-26. Published online February 29, 2016; DOI: https://doi.org/10.3393/ac.2016.32.1.20

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20 Web of Science
21 Citations

Abstract PDF

Purpose

The purposes of this study were to investigate the distribution of the visceral fat area (VFA) and general obesity and to compare visceral and general obesity as predictors of surgical outcomes of a colorectal cancer resection.

Methods

The prospectively collected data of 102 patients with preoperatively-diagnosed sigmoid colon or rectal cancer who had undergone a curative resection at Pusan National University Yangsan Hospital between April 2011 and September 2012 were reviewed retrospectively. Men with a VFA of >130 cm² and women with a VFA of >90 cm² were classified as obese (VFA-O, n = 22), and the remaining patients were classified as nonobese (VFA-NO, n = 80).

Results

No differences in morbidity, mortality, postoperative bowel recovery, and readmission rate after surgery were observed between the 2 groups. However, a significantly higher number of harvested lymph nodes was observed in the VFA-NO group compared with the VFA-O group (19.0 ± 1.0 vs. 13.5 ± 1.2, respectively, P = 0.001).

Conclusion

Visceral obesity has no influence on intraoperative difficulties, postoperative complications, and postoperative recovery in patients with sigmoid colon or rectal cancer.

Citations

Citations to this article as recorded by

Preoperative body composition metrics as predictors for outcomes in colorectal cancer surgeries
Dorsa Salabat, Asma Mousavi, Shayan Shojaei, Razman Arabzadeh Bahri, Hanieh Radkhah
Annals of Medicine & Surgery.2025; 87(4): 2243. CrossRef
Impact of visceral obesity on postoperative outcomes in colorectal cancer: a systematic review and meta-analysis
Yulong Wang, Xijuan Liu, Xiao Feng, Xing Jiang, Lili Huang
Frontiers in Oncology.2025;[Epub] CrossRef
Impact of visceral fat area on short-term outcomes in robotic surgery for mid and low rectal cancer
Shuai Zhao, Yue Ma, Ruiqi Li, Jiajie Zhou, Longhe Sun, Qiannan Sun, Wei Wang, Daorong Wang
Journal of Robotic Surgery.2024;[Epub] CrossRef
Does the visceral fat area impact the histopathology specimen metrics after total mesorectal excision for distal rectal cancer?
M Gachabayov, DM Felsenreich, S Bhatti, R Bergamaschi, Seon-Hahn Kim, Guglielmo Niccolo Piozzi, Rosa Jimenez-Rodriguez, Li-Jen Kuo, Tomohiro Yamaguchi, Fabio Cianchi, Oktar Asoglu, Vusal Aliyev, Dejan Ignjatovic, Yosef Nasseri, Moshe Barnajian, Dorin E. P
Langenbeck's Archives of Surgery.2023;[Epub] CrossRef
Visceral obesity and anastomotic leakage rates in colorectal cancer: a systematic review and meta-analysis
Linchong Yu, Wenjiang Wu, Shijun Xia, Yue Li, Zhigang Xu
Frontiers in Oncology.2023;[Epub] CrossRef
Research Progress in the Application of Visceral Fat in Gastric Cancer
桂芳崔
Advances in Clinical Medicine.2023; 13(12): 20585. CrossRef
Impact of Preoperative Visceral Fat Area Measured by Bioelectrical Impedance Analysis on Clinical and Oncologic Outcomes of Colorectal Cancer
Kyeong Eui Kim, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Nutrients.2022; 14(19): 3971. CrossRef
Computed Tomography Assessment of Fat Distribution and Staple-Line Leak Risk After Sleeve Gastrectomy
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Visceral Fat and Anastomotic Leakage After Colon Cancer Resection
Wouter M. Verduin, Anne-Loes K. Warps, Rick van den Helder, Hieronymus J. Doodeman, Alexander P.J. Houdijk
Diseases of the Colon & Rectum.2021; 64(2): 163. CrossRef
Visceral obesity is associated with lower stage colon tumors in males without survival advantage
Ana Silva, Francisco Gomes, Sofia S. Pereira, Mariana P. Monteiro, António Araújo, Gil Faria
Surgical Oncology.2021; 37: 101606. CrossRef
The Relationship Between Colorectal Cancer and Abdominal Adipose Tissue Distribution
Fatma Esra BAHADIR ÜLGER, Ümit AKYÜZ
Journal of Contemporary Medicine.2021; 11(3): 288. CrossRef
Impact of subcutaneous and visceral fat adiposity in patients with colorectal cancer
Jin-Mok Kim, Eric Chung, Eun-Suk Cho, Jae-Hoon Lee, Su-Jin Shin, Hye Sun Lee, Eun Jung Park, Seung Hyuk Baik, Kang Young Lee, Jeonghyun Kang
Clinical Nutrition.2021; 40(11): 5631. CrossRef
Impact of Visceral Fat Area Measured by Bioelectrical Impedance Analysis on Clinico-Pathologic Outcomes of Colorectal Surgery
Kyeong Eui Kim, Woo Jin Song, Minji Seok, Sung Uk Bae, Woon Kyung Jeong, Seong Kyu Baek
Journal of Clinical Nutrition.2021; 13(1): 17. CrossRef
Impact of adiposity on staging and prognosis of colorectal cancer
Ana Silva, Gil Faria, António Araújo, Mariana P. Monteiro
Critical Reviews in Oncology/Hematology.2020; 145: 102857. CrossRef
Impact of visceral obesity and sarcobesity on surgical outcomes and recovery after laparoscopic resection for colorectal cancer
C. Pedrazzani, C. Conti, G.A. Zamboni, M. Chincarini, G. Turri, A. Valdegamberi, A. Guglielmi
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Which obesity-associated parameters can better reflect the risk of the occurrence of the anastomotic leakage?
Zeyang Chen, Jiejin Yang, Zining Liu, Yuyang Zhang, Jiali Sun, Pengyuan Wang
Scandinavian Journal of Gastroenterology.2020; 55(4): 466. CrossRef
BMI May Be a Prognostic Factor for Local Advanced Rectal Cancer Patients Treated with Long-Term Neoadjuvant Chemoradiotherapy

Hengchang Liu, Ran Wei, Chunxiang Li, Zhixun Zhao, Xu Guan, Ming Yang, Zheng Liu, Xishan Wang, Zheng Jiang
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Influence of Visceral Fat in the Outcomes of Colorectal Cancer
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Digestive Surgery.2019; 36(1): 33. CrossRef
Visceral fat area, not body mass index, predicts postoperative 30-day morbidity in patients undergoing colon resection for cancer
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Assessment of Computed Tomography (CT)-Defined Muscle and Adipose Tissue Features in Relation to Short-Term Outcomes After Elective Surgery for Colorectal Cancer: A Multicenter Approach
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Impact of Visceral Fat Area in Colorectal Surgery
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Short-term Outcomes of a Laparoscopic Left Hemicolectomy for Descending Colon Cancer: Retrospective Comparison with an Open Left Hemicolectomy: Kil-Su Han, Gyu-Seog Choi, Jun-Seok Park, Hye Jin Kim, Soo Yeon Park, Soo-Han Jun; J Korean Soc Coloproctol. 2010;26(5):347-353. Published online October 31, 2010; DOI: https://doi.org/10.3393/jksc.2010.26.5.347

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Abstract PDF

Purpose

Many randomized clinical trials have been performed to treat a colorectal neoplasm with the exclusion of descending colon cancer. The aim of the present study was to investigate the difference in surgical outcomes between a laparoscopic left hemicolectomy and a conventional open left hemicolectomy for descending colon cancer.

Methods

A retrospective study of ninety patients with descending colon cancer, who underwent a laparoscopic (LAP) or open left hemicolectomy (OS) between May 1998 and December 2009 at Kyungpook National University Hospital, was performed. Clinicopathological and surgical outcomes were compared between the LAP and the OS for descending colon cancer.

Results

The baseline characteristics, including age, gender, body mass index, history of prior abdominal surgical history and tumor location, were similar between the two groups. The mean operation time was 156.2 minutes for the LAP group and 223.2 minutes for the OS group (P < 0.001). Intraoperative blood loss was significantly greater in the OS group (37.5 mL vs. 80.4 mL; P = 0.039). The postoperative recovery in the LAP group was faster, as reflected by the shorter time to pass gas and the shorter hospital stay. Pathological examinations showed the surgery to be equally radical in the two groups. The median follow-up was 21 months and there were 3 distant metastases (8.5%) during follow-up in the LAP group, but no port-site or local recurrence.

Conclusion

A laparoscopic left hemicolectomy is a technically safe and feasible procedure for treating descending colon cancer. Prospective multi-center trials are necessary to establish the LAP as the standard treatment for descending colon cancer.

Citations

Citations to this article as recorded by

Anastomotic Leak Rate and Prolonged Postoperative Paralytic Ileus in Patients Undergoing Laparoscopic Surgery for Colo-Rectal Cancer After Placement of No-Coil Endoanal Tube
Michele Ammendola, Giorgio Ammerata, Francesco Filice, Rosalinda Filippo, Michele Ruggiero, Roberto Romano, Riccardo Memeo, Patrick Pessaux, Giuseppe Navarra, Severino Montemurro, Giuseppe Currò
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